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General NPI Number Information
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NPI Number | 1730977893
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Entity Type | Individual
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Provider Name | CLAUDIA RAE SPOTANSKI PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 1 GOOD SAMARITAN WAY
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City | MOUNT VERNON
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State | IL
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Zip | 62864-2402
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Country | US
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Telephone | 618-242-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 7257 N SLIM LN
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City | ASHLEY
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State | IL
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Zip | 62808-3107
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Country | US
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Telephone | 618-791-4981
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3401X
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Taxonomy Name | Computed Tomography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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